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SIDS risk factors too often neglected

MARK COLVIN: There's been a huge public awareness campaign about the risks associated with Sudden Infant Death Syndrome.

But a review of cot deaths in New South Wales has raised fears that people haven't adequately stuck to the guidelines.

The authors say that they're particularly concerned that the risks of co-sleeping are not fully understood. But they say that co-sleeping is safe once the baby is a few months old.

Barbara Miller reports.

BARBARA MILLER: The advice on reducing the risk of SIDS appears simple. But the New South Wales Child Death Review Team concluded that too often it is not being followed.

Professor Heather Jeffery from the University of Sydney.

HEATHER JEFFERY: From 1996 to 2008 we examined 123 deaths that were sudden and unexpected and found a very high incidence of risk factors for sudden unexpected death.

In particular we found that 57 per cent of these babes were placed for sleep in a position other than recommended on their back; 73 per cent had smoking evident in their household or during pregnancy; and 60-odd per cent were in unsafe sleeping environments, in particular co-sleeping with adults.

BARBARA MILLER: A particularly troubling statistic highlighted by the report was that 25 of the 123 deaths occurred while the baby was still in hospital.

That has raised questions about to what extent midwives are following the SIDS policy themselves, or helping ensure that new mothers do.

Hannah Dahlen is President of the Australian College of Midwives.

HANNAH DAHLEN: These statistics are taking into consideration 13 years and a lot has changed in 13 years. So it's very unfair to criticise midwives of today by past standards and practises that were quite acceptable then.

BARBARA MILLER: The New South Wales Government says it will follow the report's recommendations and review compliance with the safe sleeping policy.

Hannah Dahlen again.

HANNAH DAHLEN: Look, I think if we can improve practice and improve care and improve outcomes for mothers and babies we should never ever walk away from that chance. And I think if anything it would be reassuring to the public to know that midwives are doing their job.

BARBARA MILLER: The report also recommends that more effort is put into ensuring that the message gets out about the potential risks of co-sleeping.

But the authors say the evidence suggests that co-sleeping is safe once a baby is a few months old.

Professor Heather Jeffery.

HEATHER JEFFERY: The risk is graded; it's like a dose response, it's greatest in the first month, a little bit less in the second, a little bit less in the third and not significant by the fourth. So...

BARBARA MILLER: Is the message then co-sleeping is okay after four months but definitely not okay up until then?

HEATHER JEFFERY: That is how we are interpreting this literature yes.

BARBARA MILLER: The argument that's always brought up when we talk about co-sleeping is that in some countries it's much more common to co-sleep. What do you say having done this review to that argument?

HEATHER JEFFERY: Well the way in which individuals co-sleep varies enormously. For example, individuals in China may be very different to the way parents here co-sleep.

BARBARA MILLER: In what way?

HEATHER JEFFERY: Well the babies are kept on their back and are firmly strapped into their own environment, their own sleeping environment; very much like having your own little cot or area alongside the adult bed.

So the definitions and what actually is meant by it varies greatly.

BARBARA MILLER: An International conference on stillbirth and Sudden Infant Death is taking place in Sydney this weekend. The report's authors say the issues raised by their review are certain to be hotly debated.